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This Speakout has not been edited.

By Andrzej Kurek, Littleton

There are many (too many) choices in medical coverage, ALL of them are confusing, costly, with myriads of limitations, exceptions, etc. – many times policies promising a lot and delivering a little due to the above “buts” and “ifs”. Some health insurances can be obtained through company one work for - as one reader rightfully mentioned: “situation rapidly dwindling” in this respect, other policies can be obtained directly by private person for much higher cost yet with as many “buts” and “ifs”. Very high number of citizens has no insurance at all, because they are in low income bracket (can’t afford), part timers, or working for smaller businesses, which are paying low wages and/or are not offering any health insurance. According to latest statistics the USA is 42nd in longevity (many people didn’t even know that there are so many countries). Affordability of health coverage is a big issue.

In my particular case, I’ve been laid off few months ago, my income stopped, little saving disappeared, unemployment is ¼ of previous income, many thousands to pay off credit cards, utility bills are coming and there is no way I can afford necessities, and more so insurance. My wife lately needed to use a doctor’s help, possibly MRI, and other tests, but can’t. Should the condition be slightly more serious, the only choice is to die. Doctors are feeling bad when they have to ask patient FIRST for insurance or money and if those are satisfied, THAN for patient’s health condition.

Many people question where the money is going to come from for health care for all, but that was already discussed and resolved – money is wasted by multitude of insurance organizations (especially management salary) instead of centralized health system for all, not to mention billions and billions of our tax money wasted elsewhere.

Other reader calls for “Michael Moore not to be taken seriously” – if the facts can’t be taken seriously, what can? I’m sure there are much more cases of similar kind or worst.

So, I have few questions to help me (and probably many others) to deal with situation: -How can anybody defend present system - what is so good about it if so many people are deprived from much needed medical care? The present system is loading companies with the health insurance responsibility (cost), which should not belong to them in the first place.

-How about very large number who can’t afford insurance for various reasons, many times not their own fault? What should they do?

-What to do when help is needed fast for uninsured person, but person can’t call ambulance, because of huge cost?

-What to do when help is needed in regular situation – not necessary emergency?

-Are there other options than dying or other suffering condition when person is not able to pay?

-Does person have to loose everything to qualify for any government help?

-Is it humane to let people die or push them into debt, which in many cases is already unbearable? One my say that debt is better than death, but that’s not a point – USA suppose to be the best, with high standard of living and healthy citizens.

I’m against government intervention in every aspect of live, but few basic services should be available/assured for free for ALL citizens - all developed and many other countries do that.

Those free services are: health, education and retirement.

READER COMMENTS

You claim that health, education, and retirement should be free and covered by the taxpayers through the government. Please explain your position better. Education grades K through 12 is the only thing that should be provided as it ensures an educated citizen (when you can keep politics, unions, and unfounded views from interfering). I still cannot fathom why people insist that my money, through taxes, should pay for their health, retirement, or any other social program. I can not help it if you are either to stupid or lazy to plan for and budget for your healthcare, retirement, or anything else. YOU AND OTHERS LIKE YOU NEED TO LEARN PERSONAL RESPONSIBILITY. PLAN FOR YOUR FUTURE AND DON'T EXPECT ME OR OTHERS TO CARRY YOU.

Too many choices? You have a problem with competition? Or are you simply too stupid to shop the system and act in your own best interest? What's good for you might be bad for me. Even worse if I'm forced to pay for you.

You want to keep it simple and have only one choice? That's single payer. When was the last time that you heard of a monopoly looking out for the best interest of the consumer? Monopolies produce higher prices and lower quality, competition and choices produce lower prices and higher quality.

The services you mention are NOT free. They are paid for by taxing people.

As for bad insurance I understand completely. I have three serious health conditions and have been without insurance (or horribly under-insured) most of the past 7 years.

There are many clinics that take into account your income and other circumstances. Have you tried them?
This will sound heartless but you mention credit cards and other bills. We have never had a credit card yet are facing bankruptcy because of medical bill co-pays to our insurance. We have never been able to buy insurance except through an employer.

The solution to your problems and the solution to the overall problem are simple to state but not easy to live with.

First you must ask questions. Many times doctors are seeking tests to confirm a diagnosis merely to protect themselves from a lawsuit. Your low income situation seems to make this worse as you are vulnerable to the slime bag class of attorney.
You have been unemployed for a reason. If it is because you were trying to find a job equal to your previous one it might be time to look for a lower income job. You might still have financial problems but many jobs carry health insurance including those at grocery stores including Wal-Mart. For your situation there is also the situation where you sit down and consider costs before making medical decisions. Unfortunately that is the one thing you needed to do first...before you lost your job. Do you know if you had insurance separate from employment there would be no interruption of care although there would likely be other budget constraints on your family?
If you had selected a Health Savings Account you would already be used to knowing what the costs of care are and the ways in which to minimize them. The fund might even be large enough that you would have time to get a better job instead of Hobson's Choice.

Now for the solution to the overall problem. Less whining and more thinking and working. NO ONE is guaranteed anything. We must separate health insurance from employment and make people aware of the costs of the various parts of it. Yes, there will always be some who have something better and those who have worse..it's called a free society. We make tax benefits available to individuals and remove those same benefits from employers. We open up the picture by permitting anyone to open a Medical Savings Account rather than rationing them to prevent them becoming popular. Let those who claim that government health care will be an improvement sign up for Medicaid. We can use a sliding scale to determine how much we'll charge them and then let them rejoice in the socialized medicine they are begging for.

The last part will be one of the hardest because so many refuse to see what the lawyers have done to destroy inexpensive health care. It's only x percent of the cost of health care..." some yell. Of course they don't factor in those doctors who avoid certain specialties, thus driving up the costs because of a high demand and low supply in some areas. The other cost is one you are paying when doctors schedule many expensive tests. Often the doctor is quite sure after a few simple and perhaps one complex test but they schedule all the tests in order to prevent a legal claim of negligence due to lack of tests.

As an object lesson let me give you an example of how to be an involved patient

I will be seeing an orthopedist on Wednesday. He amputated all of the toes on my left foot in June. I still have a cast on that foot. Since it will cost me 50 dollars to see him I warned his nurse I'd not be leaving in a new cast. If they want to take this one off fine. But to pay to have one put on merely to protect the doctor from my lawsuit is foolish. The prosthesis was supposed to be ready two weeks ago. Doctors like to have that ready because it seem so simple many patients will not return for follow up visits unless the doctor keeps them in a cast until the prosthesis is ready. That is how another orthopedist explained it to me.

Basic plan for both of us is the same. Study the problem, plan your care and make certain your doctors listen to you.

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